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NEW DELHI: A first-of-its-kind study giving a state-wise projection of cancer incidence in India till 2025 predicts that the highest number of cases will be reported from rural Uttar Pradesh, followed by Bihar and West Bengal. Tamil Nadu will see the most cancer cases in urban areas among all states by 2025.

The study, by researchers at the Mumbai-based International Institute of Population Sciences, says India’s cancer burden appears set to rise to nearly 1.6 million by 2020 and 1.8 million by 2025. Published in the Journal of Cancer Policy, the study says the estimated 4,27,880 cancer cases in urban India in 2015 is likely to go up to 6,37,762 by 2025.

“The corresponding estimate of cancer cases in rural India is 9,45,005 in the year 2015 and increases to 11,58,213 by 2025. Further, overall cancer cases are likely to go up from 13,72,885 cases in 2015 to 17,95,975 cases in 2025,” it says. Also, the number of cases is highest in rural areas in most states.

Rural UP has the highest burden of cancer cases followed by Bihar and West Bengal in 2015 and will continue to increase till 2025. Among urban males, the estimated number of cancer cases is highest in UP while it has been low in both males and females of Lakshadweep, Daman, and Diu, and Sikkim.

The number of cancer cases among urban females is highest in Tamil Nadu, followed by Uttar Pradesh. Tamil Nadu will also see the highest number of cancer cases among all states in urban areas by 2025. The major cancers in males for the year 2025 will be lung, mouth, prostate and tongue while in females, they will be breast, gallbladder, cervix uteri, lung and ovary. The estimates of these cancer cases (except cervix uteri) will keep increasing in both rural and urban areas whereas cervix uteri will be on a decline, the study predicts.

It also mentions that while the magnitude of the cancer incidence projections by different sites, age and sex based on different methods exists till 2026, there is no visible study estimating the incidence for all the states and union territories in India. “Present analysis will help the policy planners and administrators in prioritizing the resources and planning the cancer control programmes at the state level,” Murali Dhar, co-author of the study, said. “In the past, studies applied pooled risk of cancer for all the states whereas the present study did state-level best possible assessment of risk. This was done by taking risk observed in the registry with the state or in the neighbouring states”.

The study highlights that one of the major causes of cancer is tobacco, which is related to 24.4–65.2 per cent of cancer in males and 6.9– 42.3 per cent of cancer in females in India. The highest tobacco-related cancer is lung and mouth, which are the almost prevalent form of cancer in men. For women, who are largely affected by breast cancer, a number of factors are responsible which include highfat diet, delayed age at first pregnancy (more than 30 years), and late age at menopause.

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